Welcome back to the podcast Surgery, ICU rounds.

I've been gone with some family vacations for the past couple of weeks, and I appreciate your patients.

I hope you've enjoyed your summer as well, if I say summer.

We're going to pick up today with the topic of thermal injury and some issues of soft tissue infection.

This is part of a talk that I'm giving at the Society for Critical Care Medicine's board

review course in Chicago.

It's a pretty big topic, and frequently like these board review courses go, they're

often trying to get a tremendous amount of material in a very short period of time.

So I'm producing this podcast somewhat to augment the information that's been presented

in the presentation at the Critical Care Academy, as well as make it available to our residents

at Vanderbilt or anyone else who may come across somebody who has a thermal injury.

This is clearly something that has a great interest to me since the majority of my practice is burn surgery and burn critical care.

Burns, roughly about 2 to 2.5 million people are burned in the United States each year. The vast majority of these patients receive their care in the local community, either with their primary care providers or their local emergency departments.

Mortality is the highest in the very young and the very old.

What we like to call the extremes of age.

38% of burns are less than the age of 15 years of age.

Now this is something that people need to keep in mind is that about one out of five children

that a mixed adult and pediatric burn unit sees, about one out of five children that a mixed adult and pediatric burn

unit sees, one out of five patients will be a child.

One out of five of those children will be victims of abuse or neglect.

Next to beating children, burning them is a very common type of child abuse.

One of the first things people want to do when they come across a patient who has a burn,

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